This is an especially poignant issue for erp, who is 76 years old and would like to lose weight for her upcoming knee replacement surgery, but cannot walk.

This is the toughest possible scenario for weight loss:

Whether for genetic (X vs Y chromosome) or hormonal reasons, women are more prone to putting on weight than men. (Men are more prone to diabetes.)

Hormonal changes after menopause seem to make it tougher for women to lose weight.

A petite woman doesn’t need as many calories as a larger person … but her micronutrient needs, and thus her appetite, may still be high.

Aging brings more efficient energy utilization and reduced energy expenditure. Thus, the elderly have a smaller energy “sink” in which to dispose of excess fat. A teenager can eat like a horse and stay thin; not so an older person.

An injury that prevents walking makes it even harder to burn off fat. Walking is a tremendous aid to fat loss.

Designing a weight loss diet for someone like erp really forces a hard look at how to optimize a weight loss diet. Get it even a little bit wrong, and the diet either won’t work for weight loss, or will be malnourishing.

The Three Keys for Weight Loss

The three keys for an effective and healthy weight loss diet, as I see it, are:

Elimination of food toxins. Food toxins are the primary cause of obesity and you can’t expect to cure a condition by causing it!

Perfect nourishment. The diet should be as nourishing as possible. The dieter should be in the “plateau range” of every nutrient – vitamins, minerals, organic molecules, carbs, protein, and fats.

Calorie restriction. You have to be in energy deficit to lose weight.

The main food toxins to avoid are fructose, polyunsaturated fat, and wheat (see Why We Get Fat: Food Toxins). In my advice to erp, I suggested replacing some of her fruit with “safe starches” like potatoes, and replacing her PUFA-containing nuts with low-PUFA macadamia nuts or other foods.

But the harder part is achieving a calorie restricted diet when so few calories are being expended, and yet avoiding malnutrition. How may that be done?

Eat Protein and Carbs; Reduce Fat

This may surprise many readers, since we’re fat-friendly, but there should be no reduction in carb or protein consumption on weight loss diets. Calorie restriction should come out of fat.

The Perfect Health Diet “plateau range” for carbs and protein is 600 to 1200 calories. Eating less than 600 combined carb+protein calories per day raises the specter of either protein deficiency (leading to hunger) or glucose deficiency (leading to zero-carb dangers).

So if a typical daily intake is 400 carb calories and 300 protein calories, there’s really not much room to cut protein or carbs.

Remember that the body doesn’t have a significant store of carbs; the body’s total glycogen supply amounts to about a day’s needs. Nor does it have a store of protein, apart from skeletal muscle; and you don’t want to lose your muscle.

But it does have a large store of fat – those adipose cells that you want to shrink.

So to conserve muscle and reduce fat tissue, you have to eat your normal allotment of protein and carbs while restricting fat intake. As long as there is no serious dysfunction of adipose cells, they will release fat as needed to meet the body’s fat needs. And that’s what you want – fat being moved out of adipose cells to be burned.

So your calorie-restricted weight loss diet will be just as nourishing as your regular diet. Only the source of the nourishing fats – adipose cells instead of food – will be different.

Eat Nourishing Fats

But not all fat can be removed from the diet. The reason is that not all nutrients found in fat-containing foods are stored in adipose cells.

You see, fats are stored in adipose cells as triglycerides. But we need to get other lipid molecules, not just fatty acids, from food. The really crucial molecules are the phospholipids, especially phosphatidylcholine.

Choline, inositol, and a few others are organic molecules are bonded to fats in cellular membranes. We need to obtain these from our foods in order to be well nourished.

The easiest way to do that is to eat 3 eggs a day and a ¼ pound beef liver once a week.

Another type of lipid that may be missing from adipose cells are omega-3 fats. Balancing the omega-6 to omega-3 ratio is helpful against obesity, and most people are omega-3 deficient. So eating up to 1 pound of salmon or sardines per week may assist weight loss.

Beef and lamb – meats that are low in omega-6 fats – would be good choices for any additional meat.

Be Super-Nourished

The body’s appetite regulation mechanisms are highly attuned to your micronutrient needs. Micronutrient deficiencies will tend to induce a strong appetite for food, as your body tries to get you to obtain more nutrition. This could be a major reason why “empty calories” such as cotton candy are fattening.

Keeping Calories Down

What is the minimum calorie intake that meets all these nutrient considerations? Eggs, salmon, and beef have more fat than protein, so if you’re aiming for 400 carb calories and 300 protein calories, you’ll probably eat at least 500 fat calories per day. So it would seem to be impossible to go below about 1200 calories per day while still being well nourished.

The place to cut calories, then, is the extra fats. Perfect Health Diet favorites like butter, coconut oil, and cream are, sadly, top candidates for reduction.

Of course, the more active you are, the more you can include those fats.

For less active people, the Weight Loss Version of the Perfect Health Diet becomes similar to a lot of popular diets. Many diets recommend a roughly even calorie distribution, with 30-40% of carbs, protein, and fats. This is what a calorie-restricted version of the Perfect Health Diet should look like too.

So, the perfect day in a weight loss diet: soup, potatoes or other safe starch, salmon, eggs, vegetables. Not too much fat in the sauces!

A good meal might look like this:

Mash the sweet potato with eggs instead of butter, and this would fit our weight loss recipe.

Conclusion

It’s a little humbling that I’ve started 2011 with 5 posts on the subject of healthy weight loss, but have only scratched the surface of this complex topic.

For instance: In the book we used the rubric “metabolic damage” to describe the biological dysfunction associated with obesity. But we never really chased the complex biology of exactly that damage consists of – and how it can best be healed.

Today, I’ve presented what I believe is the best strategy for healthy weight loss. But other techniques – such as ketogenic dieting, intermittent fasting, exercise, and more – can contribute to healing the metabolic damage of obesity. As 2011 goes on, I’ll return to this topic.

I am intensely interested in the experiences of anyone trying to lose weight using our diet, and I hope that together, we can understand the disease of obesity better, and figure out good ways to achieve both healthy weight loss and a permanent recovery from metabolic damage of all kinds. So please, if you are trying to lose weight, keep me posted on your experiences, whatever they may be!

392 Comments.

Helo Eric,
how often and how much you can eat chicken livers week? I know that the beef liver eat only 200g due to copper, and as with chicken liver? Can I eat every day?
My husband is training bodybuilding, and in liver is a lot of nutrients, but is not it harmful to eat it every day?
How often do you eat the kidney?
Is innards can be consumed raw in the form of a cocktail?
Thank you very much.
Best regards
Emilia

You can eat more chicken liver than beef liver (as it’s lower in copper), but you can eat too much of anything. I think 500g per week of chicken liver should be safe (if that’s the only liver you eat). If you want more than 500g, ask Paul if I’m being too cautious (on Monday or Tuesday, once he returns from the retreat and recovers from travel).

Eat enough kidney to bring your selenium intake to 200 mcg per day on average. That probably means about:

– 300g per week if protein intake is low and comes mostly from land animals;

– 150g if protein intake is high and comes mostly from land animals, or is low and comes mostly from seafood;

Yes. Potatoes that are starting to go bad — either sprouting, or have a green tint to their skin — have high concentrations of poisonous glycoalkaloids, and should not be eaten.

But fresh potatoes have much lower concentrations of poisonous glycoalkaloids, so are safe. If you are still worried, you could peel your fresh potatoes, which will reduce the glycoalkaloid content even further (at the cost of loosing some of the beneficial nutrients too).

I understand. I can eat potatoes without fear even daily?
I do not like rice and you recommend only rice or potatoes.
One more question about tomatoes. I read that belong to the nightshade vegetables such as potatoes.
Nightshade plants strongly interfere with the operation of our brain and affect the immune system. It is associated with chemicals called glycoalkaloids, which, for example. Plants use to scare the animals who want to eat them. It’s so natural pesticides … for example. solanina or tomatine. Ingestion of causing gastrointestinal irritation and affect acetylcholine located in the brain. This may lead to leaky gut and excessive stimulation of the immune system. For example. In that tomato is a type of glikoalkaloidu, which is used in the production of vaccines to ensure that the patient obtains immunity against the virus, which is grafted.
Moreover, threatening nightshade comprise lectin as well as saponins, like cereals and legumes and unfortunately example. Tomato contains the type lectins, which quickly enters the bloodstream and contributes to the development of leaky gut.
What do You think about it?
Best regards
Emilia

Yes, you can eat potatoes daily (in which case I would peel them). But you could also eat taro (another safe source of starch) as an alternative. There are also safe half-starchy-half-sugary plants like sweet potatoes, winter squashes, or plantains; you could, for example, eat 2 pounds of sweet potatoes to replace 1 pound of potatoes plus 1 pound of bananas.

Hello Eric,
I’ve checked my diet on Nutriondata. My diet contains 7400mg of Omega 6 and Omega 3 only 679mg in the days without fish. Is not it too low levels of Omega 3? Everywhere write that the ratio of omega 6 to omega 3 should be 4: 1, but I read in the book of Paul, the ratio is not as important as the fact that the amount of omega 6 has to be low?
Thank you for everything.
Best regards
Emilia

Hello,
is Bulletproof Coffee is good? I know that drinking coffee on an empty stomach with MCT oil promotes the formation of autophagy. But whether the addition of butter does not interfere with this process?
Best regards
Emilia

Hello,
is Bulletproof Coffee is good? I know that drinking coffee on an empty stomach with MCT oil promotes the formation of autophagy. But whether the addition of butter does not interfere with this process?
Does adding Whey Protein 10g inhibits autophagy process?
Best regards
Emilia

Hello Paul,
thank you for your answer.
And is the ability to effectively build muscle using intermittent post?
I know this is good for health and longevity, but would allow the development of muscle as we eat only 6-8 hours? Everywhere Pisz To keep an anabolic state, provide protein every 3 hours, etc.
Best regards
Emilia

To effectively build muscle, the key is to eat enough food. With the same food intake, intermittent fasting will lead to more muscle than would continuous eating, because it elevates growth hormone. Intermittent fasting only puts muscle at risk if it leads to undereating.

Hello Paul,
Thank you again for your reply.
I depends on building muscle and I still have some questions:
1. So do not have to deliver the protein from the morning every 3 hours, just by 8 hours of my eating? I’m afraid that lack of protein for my muscles.
2. Is the morning during fasting intermittently I can drink a cocktail vegetable, whether it is best not take anything?
3. What about BCAA, can I take during fasting.
4. Or maybe it is better to eat the traditional 5 meals a day for 5 days. And two days to eat only 600 calories?
5. The most important of my question, which is better – in every meal of the day added for carbohydrates or whole day to eat fat and protein meals without causing a jump of insulin and post-training meal only eat carbohydrates. Probably the second version is much healthier.
Can you tell me any tips how to best build muscle and not lose health.
I’m sorry too many questions.
Best regards
Emilia

You are amazing!
You have worn out this forum with question after question – most of which you can Google yourself.
I have been surprised at how Paul and Eric continued to answer you and now you have the nerve to complain.

Undereating is a danger on any calorie-restricted diet. If symptoms of undereating develop, I would respond by eating more every day, rather than by introducing a cheat day. For most people, intermittent fasting and avoiding hunger during the fast is enough to avoid undereating.

Hi Paul,I bought your book recently – twice in fact (I wanted both the e-book and hard copy), and quite by chance came across Russ Crandle’s new recipe book shortly afterwards. My health problems either stem from or are certainly aggravated by, my weight issue – I am two people! Your findings give me real hope that I can heal as I lose weight so I’ve started overhauling my diet accordingly. Wheat and other cereal grains were the first to go and I’ve already noticed the aches in non arthritic joints have pretty much disappeared. My knees however really need the weight lifted, so I’m now keen to fine tune the diet. I’m already back in the gymn, but I know from past experience that diet plays the biggest part in weight loss. Here’s my problem – you say on your website no reduction in carbs or protein. In your book you say reduce the fat to around 30% and Russ Crandle says reduce carbs and increase fat. Which is it? I’m using my fitness pal as a tracker and have set the goals to 35% protein, 35% carbs and 30% fat. Could you advise please on what you feel the best ratios are?

Follow our advice. Here is a talk in which I give more guidance on weight loss: http://perfecthealthdiet.com/2014/08/ancestral-health-symposium-tak-weight-loss/. Lifestyle factors (light exposure, meal timing, stress, etc) are as important as diet. Dietary keys are natural whole foods, balanced and dense nutrition, support for the gut with PHD supplemental foods and intermittent fasting. In general oils are the source of “empty calories” on PHD so a good thing to cut back on, especially since you’ll be releasing fats from adipose tissue.

Thanks for such a quick and clear response – and the link to your talk; I’ll head over there now. I meant to say earlier – the apple diagram is great, such an easy reminder that I’m copying one down small enough to laminate and keep in my purse (wallet).

This is an intriguing approach that flies in the face of the gorge-on-bacon school of Paleo weight-loss. It actually is more in-line with the moderately successful fitness approach (but with much higher quality foods, of course).

I have a practical question. Reducing ultra fatty foods is a conceptually easy task, and requires no careful tracking of macronutrients. On the other hand, if we get a little sloppy and overshoot our calorie goal for the day (very easy to do, as we all know), carbs and protein will quickly surpass recommended amounts. Is this okay, or are we better off on the regular PHD unless we are carefully tracking macros?

I’ve been returning to this post over the years, but I would love to see more updates related to weight loss!

After various attempts at addressing some gut infections and parasites I am very underweight, dizzy, etc. I need to eat many more calories a day, I expect well over 3000 (I am a 22-year-old male, 20 pounds under my healthy weight). If I want to keep as close to PHD as I can, what is The best way to increase calories? Should I keep perfect health diet ratios and just increase the amount of food that I eat? Should I not go too overboard on protein and increase carbs+fats more? Should I still limit fructose and get more carbs from starches even if I am eating (maybe) more than 4 pounds of starches/roots a day? Or maybe, should I eat more PHD snacks as well – maybe Homeade ice creams, custards, hot chocolates between meals? Any advice is appreciated.

Yes, eat regular PHD, and focus on being well nourished rather than getting a lot of calories. (E.g. eat egg yolks not oil, potatoes not sugar). You need to restore immunity, gut barrier function, and other parts of your body. Weight normalization will come when you finish fixing diet and health.

Thanks for the reply. I’ve been eating PHD for several weeks but the past few days have been almost doubling the amounts (really feeling like I need it) and feeling much better. I mean to ask, is this doubling of the food quantities OK for a short period of time (a few weeks perhaps)?

OK, here goes! I was told from my Dr to buy your book. After my bloodwork came back, she told me I had an infection in my body and this book would change my life. This was just less then 1 week ago. I read the book in one sitting, and was naturally very excited to get well. My back story…I have had HBP since the first time it was taken at age 18. I never weighed more than 130 pounds at 5’8″, so I never worried about what I ate, until I became toxemic with my first child at age 22. I read every label, making sure not to eat anything with added salt. At 27, I was on a beta blocker and taken off, because of my good work with eating no salt and exercise. I weighed 130-135 my whole life until I became extremely dehydrated, had thrush in my mouth and throat and was hospitalized at age 48. I was on medications, including attenolol with hctz, and was being treated for fibomalagia with soma and tramadol. Bloodwork and tests came back in the hospital that I had CKD, barely any vitamin c, b 12 and potassium. I was given pottasium by an IV. Ouch! I was suffering with IBS too, severe cramping, hours in the little girls room was horrible. No one could tell me what was wrong. My back was bad,( stenosis) I spent years with many chiropractors. I have now a myriad of health issues, and had gained over 80 pounds over the next 10 years. I spent many years in bed, I suffered with anxiety since I was 8 years old, it got so bad, I was not me anymore. I could hardly walk, my feet now swell every hour if I’m on my feet, and all the Drs did was ” band-aids” me up. I hardly ate, my husband would call me everyday at lunchtime to ask me,” WHAT DID YOU EAT TODAY?!” Truth, I was afraid to eat, Everytime I ate it seemed I would gain another pound. Mind you, even though my feet hurt, my hands hurt, my body hurt, I exercised everyday. Everyone told me to eat, that I was not active enough, that I was malnourished, and I knew they were right, but still I ate hardly anything, so how was I gaining?! My new Dr, after 10 years, told me after my bloodwork came back told me I had an infection, she told me to get this book, she put me on prescription d, ( this I’ve done before) and now I am prediabetic. I see her on may 10, I want to make her proud and see that number down (a1c was 60, I always had a very low a1c prior) and of course, I want to see a low number on that scale!! I would, and so does my Dr. wants me all the band-aids meds too. Asthma rescue inhaler, sinus meds, syngulair, norvasc, attenolol 100 mg a day, Norco, soma, meclizine, klonopine, benedryll, Mucinex, I’m sure I’m missing something. But I’d like to be missing it all!! For years I thought I was carb sensitive, so I didn’t eat breads, etc, and when I did I suffered terribly for it. Hours of cramps, but I do not have celiacs disease. The gastro said IBS and divitulitus. OK, so in April I moved and found my new Dr. She knew even prior to bloodwork that I had a gastro infection and put me on a 3 week course of cipro and flagyll. 10 years of suffering gone! So, here I am, wanting to lose weight, have the book, I’m boiling eggs as I write this, but I have no earthly idea how to lose weight and get better, even with the book in hand. So, HELP!! LOL what do I eat? I know not to eat carbs, except potatoes, white rice, no peanuts, I can’t possibly eat the liver ( well maybe foie gras!) I was an anemic child, mom would try and trick me, I still can’t get passed the smell, it makes me vomit (sorry about being so graphic) if someone could help me, I will listen, I am very desperate. Mind you, since I moved in April, I do not stay in bed anymore, no matter how bad I hurt and walk or bike or do something besides cooking and cleaning everyday, but the scale doesn’t budge. But I have not gained either, and no one would ever think I weigh 200 pounds, but I do, and I have to get well. Thank you for reading my story which turned into a book! I hope someone out there can help me, and I thank you in advance! Lost, joanne

For weight loss, start by watching this video: http://perfecthealthdiet.com/2014/08/ancestral-health-symposium-tak-weight-loss/. Keys include intermittent fasting, circadian rhythm entrainment, and good nutrition. Re-read chapter 17 of the book and Part V on lifestyle. Also, minimize omega-6 fats with the exception of eating 3 egg yolks per day. Saturated fats will be your friend, but don’t try to get a lot — just make the fats you do eat as saturated as possible, apart from eating salmon once per week. Make sure you optimize vitamins A and D to prevent your gut problems from coming back. If you won’t eat liver then you need to supplement vitamin A and copper.

Please thank your doctor for recommending our book, and come back later and let us know how you are doing.

Hi Joanne- The PHD book is incredible. Don’t be surprised if you do numerous re-reads! You might like a series off instructional videos that help explain the gut micro-biome. The product offered certainly is not required….but the explanations are quite good. Elixa-probiotic.com. Click videos.

If you are 6’4″ then 90 kg is a normal weight (BMI 24.1). It may be that you have weight in the wrong places and have trouble gaining muscle mass, that is likely due to inflammation originating in the gut. So you should work on reshaping your gut microbiome and improving immunity. Vitamin A, D, glycine/taurine/NAC, vitamin C, vinegar, egg yolks, intermittent fasting, circadian rhythm entrainment, and PHD will help you.

I’ve been confused about fat loss and I’ve been periodically thinking about this weight-loss post for years. I can’t take it anymore! Please help! 😥 I just don’t understand how it’s possible to burn any fat at all without losing all your skeletal muscle.

Let’s say all of my body’s basic glucose needs are met through glucose intake, and I’m consuming the minimum amount of protein to be in nitrogen balance. If I go into a caloric deficit by reducing my fat intake, won’t my body just burn all of the glucose in my blood and glycogen stores to make up for the deficit before it burns any fat?

And if my body does burn through all of my glycogen stores before paying off the caloric debt, won’t that in turn create a glucose deficit that causes my muscles to be converted to glucose, which will again be used to pay for the caloric debt? It seems like a vicious cycle that will turn me into a fat skeleton?

How do people lose weight instead of becoming fat skeletons??!!! Of course I know it’s possible, but I don’t understand how!!! 😕

Thanks Paul! So interesting that you would consider circadian rhythms to be so important. I think I get it now. I guess that in a caloric restriction the body will burn both glucose and fat simultaneously throughout the day with a varying glucose/fat burn ratio that’s a function of the hormonal environment?

Yes. You want to supply enough glucose that cells that like glucose, such as the brain and immune system, can get what they need, while other cells that like fat can get it whether from diet or internal stores. Then by restricting fat a bit, they will draw down internal fat stores. Overall macronutrient utilization will be the same as on PHD without a caloric deficit.

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